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C� <br />J <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />ADDRESS: � � PyOPERTY TAX ti P RMIT �F � <br />� e ;�►. `?� S�l�-. 5t.� , ��c�-�:-►E- �� .� � � � Q�c� �'� _3 r� n c� �. i� i 2l I C� 'Z�� <br />for new construction: ShoR PlaUsubdivision Lot No. (attach copy of long legal description) <br />t �1(�� �.� `g � � � i� Phone/E-mail �� � � � .j �� � � <br />I p l� Z %�` : Y�_ � �; City/State/Zip � 1r` ��-''H" �i-� � � � 1 C! � <br />�NT: _ Owner _ Owner's Agent _ ConVactor _ Contractors Agent _ Tenant fm�gf Pro�ae a �ener or �onser,c rrom me owr��3r to ao woM in me sPace> <br />CTOR ���' S ��h L 8 I Lic. # COE Bus. Lic. # <br />��i � �. 7 � � _ SL�,,� Phone/Email ��� y���, <br />� � �► n-�- !� � 4 �- I �s s' <br />BUILDING PERMIT APPLICATION <br />)NTACT FOR PERMIT � � ��,�� y <br />2 ��� Z 4 ��e y � '�� 1 <br />�ne/E-m il p a� ��iY�� S ZC` ['� 3� c'�-�'a ctaS"� - tl�T <br />)NTRACT PRICE OF WORK �Z �� L�� <br />F�cisting Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas Eiectric other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: _ New Addition Remodel Repair T.I. _ Sign _Sprinkler _Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) :��s f:! �..f -� s.�y �?� �c-S �. �� t;�'� <br />�1tt � 1c i S�rt� w :� Y'e-lG_S3 '�Gu� � "�'( [% �-.r- � lG:.+�S . .i r.�-i-� 1 l % �' `'r. c7 �F <br />�^�1.�w �h�Nhr��s «nd 2 �«{�:r���-�� cX�s�'-+'� (� �=•n,-�-e-rn�:.S cta,d Z. �.�ct:n�� <br />� � �D • � u_ '�t �'F'� i Yi j� Ci c� G. 5 cc� �csf' � n.Y�''1 �( <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLI�ATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (p) of �xtures <br />A/C - air handlin units <br />Forced air s stems <br />Gas pipin <br />Water heater <br />Gas fireplace <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Ducting <br />Other <br />ISUPPRESS <br />Number of Heads <br />of Project: _New _Addn _Alteration ,Repair <br />Show Number (#) of fixiures <br />I Toilet <br />Shower <br />Kitchen sink 8� <br />Clothes washer <br />Water heater <br />Sink (service/bs <br />Floor drain <br />Grease tra <br />Medical Gas <br />Other: <br />Other: <br />I hereby certiFy that I have read and examined this application and know the same to be true and correct. All provisions of laws and ord'mances goveming this lype of work will be complied <br />with whether specified herein or not. The granfing of a permit dces not presume to give authoriry to violate or cancel the provisbn of any other state or local law regulating consfruction <br />That I am authorized by the owner of this property to perfortn lhe work for which application is mede and I compy with the State Contractors Law 1827 RCW and 296.200A WAC. <br />��-� t� 23 2 <br />OwnedAuthorized Agent Signature Date (Revised 6/2012) <br />� /� <br />